NPIMap

Individual provider Active NPI

Justin Segura

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1609390236
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.004501 Issued in IL
Practice address
9820 N Central Ave Unit 110
Phoenix, AZ 85020-1054
Phone
(309) 299-8833
NPI assigned
Jul 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.004501 IL Primary

Addresses

Primary practice location

9820 N Central Ave Unit 110
Phoenix, AZ 85020-1054

Mailing address

9820 N Central Ave Unit 110
Phoenix, AZ 85020-1054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
242.004501ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegiant Therapy LLC. Speech-Language Pathologist Current Accepting new patients
Achievement Therapy Services Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1609390236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9820 N CENTRAL AVE UNIT 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850201054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 N CENTRAL AVE UNIT 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850201054",
            "telephone_number": "309-299-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGURA",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.004501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.